Life Cover Membership handbook

Friends Life Individual Protection

Life Cover

Membership handbook

FLIP/4574/Jan14

handbook

Contents

Welcome 3

General definitions 5

Your membership - life cover 9

Additional options 12

What you are covered for 18

What you are not covered for 20

Changes to your membership 22

Premium options 28

How to make a claim 31

Your right to cancellation 35

General information 37

Welcome

Welcome

Thank you for choosing life cover from Friends Life Individual Protection Friends Life Individual Protection products are provided by Friends Life and Pensions Limited, part of the Friends Life group. Friends Life flexible financial protection is the umbrella plan which provides cover through a series of separate memberships for different types and levels of cover.

Your registration certificate will show which type of membership you have. Each membership will have a separate handbook. This handbook explains what is covered by your Friends Life Individual Protection Life Cover and what to do if you need to make a claim.

Using the membership handbook The terms and conditions of this

membershiphandbook are the terms and conditions on which we intend to rely. For your own benefit and protection, you should read the terms and conditions carefully. If you do not understand any point please ask us for further information.

Where the words ‘we’, ‘us’ or ‘our’ are used, this refers to Friends Life and Pensions Limited. The words ‘you’ or ‘your’ refer to the person, or people, who are entitled to receive the benefits of the membership. Where we refer to the member(s), this refers to the person, or people, covered under the same scheme. The terms you and member may refer to the same people or different people. Words printed in bold type in this handbook are defined terms. Defined terms have a specific meaning explained in the ‘General definitions’ section.

Where we refer to you or to the member and this refers to two people, we mean both people jointly unless we say otherwise. For example, where we say we will pay the benefit to you, we mean both

conditions of this membership handbook, Friends Life and Pensions Limited will act reasonably and with proper regard to the need to treat you and our other customers fairly.

(b) The terms and conditions in your membership handbook will only apply provided that they are not held by a relevant court or viewed by the Financial Conduct Authority or by us to be unfair contract terms. If a term is unfair it will, as far as possible, still apply but without any part of it which causes it to be unfair.

6 |

General definitions

Please refer to the definitions below for information on their meanings.

Average Weekly Earnings

The measure used by the Office of National Statistics (ONS) which has replaced the average earnings index. This measure is an indicator of short-term earnings growth and provides a monthly estimate of the level of average weekly earnings per employee. Alternatively, if this measure is not published during any period of your membership the ‘average weekly earnings measure’ will be any substituted index or index of figures published by the ONS.

Benefit

The life cover benefit or the terminal illness benefit as appropriate. Commencement date

The date your membership starts, as shown on your registration certificate.

Consultant

A surgeon, anaesthetist or physician who:

•

is legally qualified to practice medicine or surgery following attendance at a recognised medical school; and

•

is recognised by the relevant authorities in the country in which the treatment takes place as having specialised qualification in the field of, or expertise in, the treatment of the disease or illness being treated.

By recognised medical school we mean a medical school which is listed in the World Directory of Medical Schools, as published from time to time by the World Health Organisation.

Endorsement(s)

Change(s) that you require and we agree to be made to your membership after it commences are recorded in the

endorsement section of your registration certificate.

Fracture

The fractures defined in ‘Black’s Medical Dictionary’ (39th edition), comminuted, complicated, compound, depressed, greenstick, pathological and simple. The fracture definition does not include any other type of fracture.

Friends Life and Pensions Limited approved hospital

A centre of treatment which is registered, or recognised under the local country’s laws, as existing primarily for:

•

carrying out major surgical operations; or

•

providing treatment which only consultants can provide

and which has been approved by Friends Life and Pensions Limited.

General definitions

Handbook

This handbook setting out the general terms and conditions of your membership. Life cover benefit

The life cover benefit as shown on your registration certificate.

Member

The person (or people) named as a member in your registration certificate. This is the person (or people) for whom cover is provided. Membership

The agreement between you and us to provide the benefit on the terms set out in the handbook and your registration certificate together with the other documents referred to in the ‘Your membership - life cover’ section. Mental impairment

Mental disorder causing incapacity which has failed to respond to a minimum of two years optimal treatment by a consultant

psychiatrist and requires the need for continuous psychotropic medication, supervision and care from a consultant and results in severe dysfunctioning and the prognosis is considered poor or worse. Occupation

A trade, profession or type of work undertaken for profit or pay. It is not a specific job with any particular employer and

Permanent

Expected to last throughout the life of the person covered, irrespective of when the membership ends or the member expects to retire.

Registration certificate

The most recent registration certificate, we issue to you.

Renewal date

If your registration certificate says that your ‘Type of cover’ is ‘Renewable term (five years)’ the renewal date will be the fifth anniversary of the commencement date and the end date of every following five year period. If your registration certificate says that your ‘Type of cover’ is ‘Renewable term (ten years)’, the renewal date will be the tenth anniversary of the commencement date and the end date of every following ten year period.

Retail Price Index

The general index of retail prices published by the Office for National Statistics (ONS). Alternatively, if that index is not published during any period of your membership, the ‘retail price index’ will be any substituted index or index of figures published by the ONS. Special condition

Any condition we set to limit your entitlement under your membership, as

Suited occupation

Any work you could do for profit or pay taking into account your employment history, knowledge, transferable skills, training, education and experience, and is irrespective of location and availability.

Terminal illness

A definite diagnosis by the attending consultant of an illness that satisfies both of the following:

•

The illness either has no known cure or has progressed to the point where it cannot be cured; and

•

In the opinion of the attending consultant, the illness is expected to lead to death within 12 months.

Terminal illness benefit

The equivalent benefit in value to the life cover benefit but only relating to a member being diagnosed with a terminal Illness. UK

England, Northern Ireland, Scotland and Wales.

We/us/our

Refers to Friends Life and Pensions Limited.

You/your

Refers to the person (or people) named as the schemeholder in your registration certificate, or any person (or people) to whom your membership is assigned. This is the person (or people) who hold the membership.

Your membership –

life cover

Your membership is made up of the following documents:

•

your application for cover

This includes your initial application and any further applications you make where your membership is varied. It also includes any declarations made at our request when you applied for cover.

•

your registration certificate and any

endorsements

These set out the current details of your membership. The ‘Special conditions’ section of your registration certificate shows any special conditions we apply to your membership.

Your registration certificate may also refer to other membershipsyou have under the Friends Life flexible financial protection plan. We explain how your registration

certificate may change in the ‘General information’ section.

•

this handbook

This contains all the general terms and conditions of your membership. It is referred to as the ‘Friends Life Individual Protection Life Cover’ membership handbook reference FLIP/4574/Jan14.

When your membership starts and ends Your membership starts on the

commencement date and is subject to you paying your first premium.

When your membership ends depends on the type of cover you have.

If your registration certificate shows that the type of cover you have is ‘Renewable term’ (either five years or ten years) your membership will end on the earliest of the following:

•

any renewal date on which you do not renew your membership or we end your membership

•

where the renewal term is five years the renewal date is before the member’s 65th birthday (or the eldest member if more than one)

•

where the renewal term is ten years, the renewal date is before the member’s 70th birthday (or the eldest member if more than one)

•

the date we pay you the benefit

•

30 days after the premium due date where you do not pay any amounts. We will allow your membership to continue if you pay any outstanding amounts within the 30 day period after it became due.

If you do not have ‘Renewable term’ cover, your membership will end on the earliest of the following:

•

the ‘expiry date’ shown on your registration certificate;

•

the date we pay you the benefit;

•

30 days after the premium due date where you do not pay any amounts. We will allow your membership to continue if you pay any outstanding amount within the 30 day period after it became due. Failure to disclose a fact, giving false information or failing to tell us of a change in your health or circumstances in relation to any question in your applicationbefore cover starts where done deliberately or recklessly gives us the right to cancel from the start any membership issued as a result and may invalidate a future claim. However, where that information was given carelessly, or the failure to disclose relevant information was careless, then we will have the right to amend the terms of your membership to be consistent with what the terms should have been based on the correct information, unless we would not have offered any terms for the membership applied for, in which case we have the right to cancel the membership from the start and return any premiums.

Your membership will end regardless of whether it was you or a member or both who misled us.

You can end your membership by writing to us providing 30 days notice to tell us at the address shown in the ‘General information’ section.

Additional options

Your registration certificate will show if your membership includes any of the following additional options. If there is more than one member, your registration certificate will show to which member the option applies or whether it applies to both. The following are the full list of additional options. These are only applicable if you have selected and we have agreed to provide the option:

•

indexation options

•

premium waiver option

•

total permanent disability option

•

fracture cover option. Indexation options

For each of these options, on each anniversary of the commencement date, we will increase the benefit under your membership. The amount the benefit increases by will depend on the indexation option applicable.

If we have agreed to provide this option, your registration certificate will show which indexation option you have of the following:

•

Retail Price Index (RPI)

•

Average weekly earnings (AWE)

•

five percent

•

three percent.

The increases for each indexation option are as follows:

Retail Price Index (RPI) option

On the anniversary of the commencement datewe will increase the benefit in proportion to the increase in the RPI during the first 12 months of the 15 month period immediately before that anniversary of the commencement date.

The maximum increase on any anniversary will be 10 percent of the benefit.

Average Weekly Earnings (AWE) option On the anniversary of the commencement datewe will increase the benefit in proportion to the increase in the AWE measure over the first 12 months of the 17 month period immediately before that anniversary of the commencement date. The maximum increase on any anniversary will be 10 percent of the benefit.

Five percent option

On the anniversary of the commencement date, we will increase the benefit by five percent a year.

Three percent option

On the anniversary of the commencement date, we will increase the benefit by three percent a year.

14 |

How does indexation affect your premiums? You will have to pay an increased premium for any increase in the benefit. Your premium will increase at a higher rate than your benefit as we will allow for member’s age and remaining term at the time of the increase in the benefit. For guaranteed premiums the increase will be based on our premium rates at the commencement date. For renewable premiums, the increase will be based on our premium rates applicable at the later of the commencement date or at the last renewal. When we write to tell you about the increase in the benefit, we will tell you about the increase in your premium. Cancelling an increase

You can cancel the increases in the benefit and your premium by writing to us within 30 days of the date of our letter telling you about the increase. If you cancel any increases we will cancel your indexation option and no further increases will be made. This will not affect previous increases. Premium waiver option

This is only applicable if you have selected and we have agreed to provide the premium waiver option, this will show on your registration certificate. If there is more than one memberwe may have agreed to cover one or both members and this will also show on your registration certificate.

This option ends when your membership ends or for any member on their 65th birthday.

If the member that the option relates to is in a paid occupation and was on the

commencement date, we will waive your premiums for the period the member is unable to do their normal paid occupation, as a result of illness and injury, provided the member is not doing any other paid occupation.

If the member the option relates to is not in a paid occupation or was not on the commencement date, we will waive your premiums for the period the member is, as a result of illness or injury, unable to do at least three of the daily activities listed below: Daily activities

Shopping - being able to get to and from the nearest shops and carry a small bag of shopping.

Cooking - being able to prepare and cook a basic meal.

Housework - being able to carry out light housework such as dusting, washing dishes and making beds.

Handling money - being able to handle basic household finances and recognise the value of money.

Taking medicine - being able to take routine medication as prescribed by a recognised medical practitioner.

Child minding - being able to care for, feed, wash and dress a child under the age of five.

Additional options We will waive your premiums until:

•

the member’s 65th birthday; or

•

the member can do their normal paid occupation; or

•

the member starts any paid work; or

•

the member becomes capable of doing four or more of the daily activities listed in this section (if the member was not in a paid occupation); or

•

your membership ends.

If, as a result of illness or injury, the member becomes unable to do their normal paid occupation or is unable to do at least three of the daily activities listed in this section, you must make a claim for us to waive your premiums before you are entitled to any waiver. To do this you must:

•

contact us to ask for a claim form; and then

•

fill in the claim form and return it to us. You must give us any information or proof we reasonably require to consider your claim both at the time of your claim and at any time when we are waiving your premiums. If we accept your claim, we will not waive your premiums until the end of the three month period following either the date the member became unable to do their normal paid occupation or the date they became unable to do at least three of the daily activities listed in this section, as appropriate. You must make your claim within six months of the illness or injury arising or as soon as

reasonably practical. If you do not, we may not waive your premiums for the period of your delay in making your claim.

During any period where we waive your premiums you must notify us as soon as practical of the member:

•

starting a paid occupation

•

no longer being incapable of doing three or more of the daily activities listed in this section

•

being capable of doing their normal paid occupation.

If you fail to do so, we may end your membership.

Total permanent disability option This is only applicable if you have selected and we have agreed to provide the total permanent disability option, this will show on your registration certificate. If there is more than one member we may have agreed to cover one or both members and this will also show on your registration certificate. This option ends when your membership ends or for any member on their 65th birthday, whichever occurs first.

With this option we will pay the life cover benefit if the member the option applies to becomes totally and permanently disabled, as defined in this handbook. Any disability must continue for a minimum of six months before we will consider it is a ‘total permanent’ disability for the purpose of your membership.

16 |

What is total permanent disability? Your registration certificate will show whether the definition of total permanent disability for a particular member is ‘own’, ‘suited’ or ‘activities of daily work’. The definitions are as follows:

‘Own’ definition

Loss of the physical or mental ability through an illness or injury to the extent that the member is unable to do the essential duties of their own occupation ever again. The essential duties are those that are normally required for, and form a significant and integral part of, the performance of the member’s own occupation that cannot reasonably be omitted or modified. The relevant consultant must reasonably expect that the disability will last throughout life with no prospect of improvement, irrespective of when the cover ends or the member expects to retire.

‘Suited’ definition

Loss of the physical or mental ability through an illness or injury to the extent that the member is unable to do the essential duties of a suited occupation ever again. The essential duties are those that are normally required for, and form a significant and integral part of, the performance of a suited occupation that cannot reasonably be omitted or modified. The relevant consultant must reasonably expect that the disability will last throughout life with no prospect of improvement, irrespective of when the cover ends or the member expects to retire.

‘Activities of daily work’ definition

Loss of the physical ability through an illness, injury or mental impairment to do at least three of the six work tasks listed below ever again.

The relevant consultant must reasonably expect that the disability will last throughout life with no prospect of improvement, irrespective of when the cover ends or the member expects to retire.

The member must need the help or supervision of another person and be unable to perform the task on their own, even with the use of special equipment routinely available to help and having taken any appropriate prescribed medication. ‘Activities of daily work’

The work tasks are:

Walking – The ability to walk more than 200 metres on a level surface.

Climbing – The ability to climb up a flight of 12 stairs and down again, using the handrail if needed.

Lifting – The ability to pick up an object weighing 2kg at table height and hold for 60 seconds before replacing the object on the table.

Bending – The ability to bend or kneel to touch the floor and straighten up again. Getting in and out of a car - The ability to get into a standard saloon car, and out again. Writing – The manual dexterity to write legibly using a pen or pencil, or type using a desktop personal computer keyboard.

Additional options

Fracture cover option

If we have agreed to provide the fracture cover option, your registration certificate will show this option. If there is more than one member we may have agreed to cover one or both members and this will also show on your registration certificate.

If the member suffers one of the fractures shown in the table below, we will pay fracture coverbenefitto you. The amount of the fracture coverbenefit we will pay is shown in the table below:

To make a claim for fracture cover benefit you must:

•

contact us to ask for a claim form; and then

•

fill in the claim form and return it to us. You must make your claim as soon as reasonably practical. We will only pay the fracture coverbenefitto you for the following fractures as defined in ‘Black’s Medical Dictionary’ (39th edition); comminuted, complicated, compound, depressed, greenstick, pathological and simple. We will not pay thefracture coverbenefit for any other type of fracture.

Where more than one of the above fractures occurs at any time, we will only pay fracture coverbenefitfor one of the fractures. You can decide which fracture you claim for. We will only pay fracture coverbenefit to you for one fracture suffered during any 12 month period. The first 12 month period will start on the commencement date and then each subsequent 12 month period will begin on each anniversary of the commencement date.

Fracture cover benefit Fracture

closed fracture of the skull open fracture of the skull fracture of the vertebra fracture of the shoulder blade fracture of the jaw

fracture of the sternum fracture of the pelvis fracture of the wrist fracture of the hand fracture of the upper leg fracture of the knee fracture of the lower leg fracture of the arm fracture of the cheekbone fracture of the foot fracture of the ankle fracture of the ribs

£1,200 £2,100 £900 £900 £900 £900 £1,200 £900 £900 £2,100 £2,100 £1,200 £1,200 £900 £900 £1,200 £600

What you are covered for

What you are covered for

Benefit

We will pay the life cover benefit to you, subject to you complying with the requirements and obligations set out in the ‘How to make a claim’ section, unless your claim is excluded by any of the

circumstances listed in the ‘What you are not covered for’ section, if, during the period of your membership, any of the following happens:

•

a member dies

•

a member becomes totally and permanently disabled (if we have provided the total permanent disability option).

We will pay the terminal illness benefit to you, subject to you complying with the requirements and obligations set out in the ‘How to make a claim’ section, unless your claim is excluded by any of the

circumstances listed in the ‘What you are not covered for’ section, if, during the period of your membership the following happens:

•

a member is diagnosed with a terminal illness.

We will only pay the benefit once, on the first of the above events to happen. We will only pay either of the life cover benefit or the terminal illness benefit and not both under this membership.

For any claim under the total permanent disability option, we will only pay the life cover benefit after the disability has continued for six months, subject to the additional terms of the total permanent disability option set out in ‘Additional options’ section.

Family income benefit

We will pay the benefit to you as an annual income where the benefit is a family income benefit, subject to you complying with the requirements and obligations set out in the ‘How to make a claim’ section, unless your claim is excluded by any of the

circumstances listed in the ‘What you are not covered for’ section. We will pay the benefit annually on each anniversary of the payment until the last anniversary before the expiry date set out in your registration certificate. If you select the indexation option your benefit will stop increasing once we pay your claim.

What you are not covered for

What you are not

covered for

We will not pay the benefit, premium waiver benefit or fracture cover benefit in any of the following circumstances:

•

where your claim is excluded by any special condition

•

where your claim is under either the total permanent disability option or the premium waiver option and in whole or in part, results directly or indirectly from:

– self-inflicted injury – intentional self inflicted injury

•

where we reasonably consider that you have misled us (deliberately or recklessly) by either giving us false information or by keeping relevant information from us relating to your membership or claim and in those circumstances we shall have the right to cancel from the start of the membership. However, where that information was given carelessly or a failure to disclose relevant information was careless then we shall have the right to amend the terms of yourmembership to be consistent with what the terms should have been based on the correct information, unless we would not have offered any terms for the membership in which case we shall have the right to cancel the membership from the start and return any premiums.

Additional terms apply to fracture cover benefit and premium waiver benefit and are found in the ‘Additional options’ section.

Changes to your membership

Changes to your

membership

There are various changes that can be made to your membership by you and by us. Changes we can make

If you have ‘Renewable term’ cover, you need to renew your membership on each renewal date. Renewal is subject to our entitlement to change the terms and conditions of your membership and/or your cover (including your premiums).

At least 60 days before each renewal date, we will write to tell you either about any changes we will make to the terms and conditions of your membership or your cover on renewal or if we intend to end your membership.

If we do not end your membership and you continue to pay your premiums, your membership will automatically be renewed and any changes to your membership will come into effect upon renewal.

Changes you can make

At any time you may write and ask us to change the terms of your membership, we will consider your request at our reasonable discretion.

If you ask us to increase the benefityou have, we can ask you to give us extra medical or financial information to allow us

If we accept your application, we will provide the increase either:

•

under a new membership governed by the terms and conditions we apply at the time; or

•

as an increase to the benefit under your membership.

Any increase in the benefit will increase your premiums.

You may want to increase the benefit you have when the member, or either member if more than one:

•

gets married or becomes a civil partner

•

gets divorced or separated

•

obtains a dissolution of a civil partnership

•

has a child, or adopts a child or becomes

the legal guardian of a child

•

takes out a larger mortgage due to

moving house or undertaking home improvements

•

is promoted by their current employer, or starts a new job with a different employer, and their salary increases.

In these circumstances, we will provide the increase to you without you providing extra medical evidence, subject to all of the following:

24 |

•

you write to us asking for the increase within six months of the event supplying written evidence to us showing that the particular circumstance has happened, for example a marriage certificate or mortgage loan offer

•

the maximum increase in the benefit for each of the above is the lower of 25 percent of the benefit on the

commencement date and £50,000; or if the member has family income benefit, the lower of 25 percent of the annual benefit and £8,000 a year

•

the total of all increases in the benefit under this option is not more than the lower of 100 percent of the benefit on the commencement date and £125,000

•

for family income benefit, the total

increases will not exceed £125,000 as calculated by the annual benefit multiplied by the remaining term under this membership

•

if you want to increase the benefit because a member’s salary has increased, the percentage increase is not more than the percentage increase in their salary

•

if you want to increase the benefit due to a mortgage loan increase this must be due to the member either moving home or undertaking home improvements

•

we still offer this type of membership at

the time you ask for the increase in the benefit

•

the member (or eldest if more than one) is under 55 years of age at the time we receive your request for an increase

•

when we accepted your initial application

for cover we did not apply premiums above one and a half times our standard rates at that time or any special conditions to your membership

•

the increase in the benefit is provided

under a new membership governed by the terms and conditions (excluding any option to increase the benefit) that we apply when you ask for the increase or, at our option, as an increase to the benefit under your membership

•

the amount by which your premiums will rise for any increase, is more than the minimum premium for this type of membership at the time you ask for the increase

•

you may only increase the benefit once for each of the reasons set out above

•

any increase due to a change made is

based on the original benefit at the commencement of the original membership

•

no changes to the membership will be made or will be effective in the event that an illness or disability has already arisen. Any increase in the benefit will increase your premiums. Your premiums will increase by the cost of providing the increase in the benefit, based on the member’s age and our premium rates at the time of the increase in the benefit.

Changes applicable for key person / shareholder protection only

Where you have taken out the membership as a business on a person working in your business (a “key person”) or as protection for your interest in a business (“shareholder / partnership cover”) or if you are a sole trader, you may wish to increase the benefityou have to reflect changes in your business or the levels of cover you need. We will allow you to increase the cover you have without providing extra medical information where one of the events set out below occurs and the reason you took out the cover was one which applies for that event.

We will only allow this subject to the applicable conditions which are set out in this section. In all cases the following conditions must be met:

•

you write to us asking for the increase within three months of the event, supplying written evidence to us to show that the particular circumstance has happened

•

the member is under 55 years of age at the time we receive your request for an increase

•

when we accepted the initial application for cover we did not apply premiums above one and a half times our standard rates at that time or add any special conditions to your membership

•

the increase in the benefit is provided under a new membership governed by the terms and conditions (excluding any option to increase the benefit) that we apply when you ask for the increase or, at our option, as an increase in the benefit under yourmembership

•

the amount by which your premiums will rise for any increase is more than the minimum premium for this type of membership at the time you ask for the increase

•

we still offer this type of membership at the time you ask for the increase in benefit

•

the membership was taken out for one of the reasons specified below as applying for the event in which you are seeking to exercise the option

•

only one increase will be allowed for the membership.

The events on which this option may be exercised together with the reasons for taking out the membership which must apply are as follows:

•

the member is employed by you and their salary has increased – the reason for taking out cover for this event must have been to protect you against losses you would suffer to your business or the costs your business would incur if the member could notcontinue in their employment

26 |

•

a business loan you have is increased – the reason for taking out cover for this event must have been to provide security for the loan and have been a requirement of the lender in making the loan, but excludes applications from sole traders on their own lives (“loan cover”)

•

the value of your interest in a business you own has increased – the reason for taking out cover for this event must have been to provide funds to purchase your interest in the business which has increased in value (“shareholder / partnership cover”)

•

where you are a sole trader and either your net relevant earnings have increased or a business loan you have is increased – the reason for taking out cover for this event must have been to provide funds for your dependants, to replace the earnings from your trade or to provide security for the business loan and have been a requirement of the lender in making the loan (“sole trader cover”).

The following conditions must be met for increases in relation to the different typesof cover:

Key person cover

•

the maximum increase in the benefit is the lower of 50 percent of the benefit at the commencement date and £250,000

•

the increase does not exceed five times

the increase in salary to which the request relates

•

any request for an increase greater than £150,000 is subject to the member making a true declaration that they are in good health and to financial evidence supporting the request for the increase

•

you cannot extend the term of your

membership.

Loan cover or shareholder / partnership cover

•

the maximum increase in the benefit is the lower of 50 percent of the benefit at the commencement date and £250,000

•

you cannot extend the term of your

membership. Sole trader cover

•

the maximum increase in the benefit is the lower of 50 percent of the benefit at the commencement date and £250,000

•

if you want to increase the benefit

because your net relevant earnings have increased the increase does not exceed five times the increase net relevant earnings

•

any request for an increase greater than £150,000 is subject to the member making a true declaration that they are in good health and to financial evidence supporting the request for the increase

•

you cannot extend the term of your

Changes to your membership

Any increase in benefit will increase your premiums. Your premiums will increase based on the cost of providing the extra benefit, based on the member’s age and our premium rates at the time of the increase in benefit.

Premium options

Premium options

Paying your premiums

You must pay your premiums in advance throughout your membership (except whilst you are receiving the premium waiver benefit). The amount you must pay, and how often, are shown on your registration certificate and any endorsements to it. If you cannot pay your premiums, contact us immediately.

Changing premiums

This section explains how your premiums may change, except for yearly increases if we have provided an indexation option - see the ‘Additional options’ section.

Whenever we change your premiums we will write to tell you about this at least 60 days before the change takes effect.

We may increase your premium in accordance with reasons set out in the ‘General information’ section of the membership handbook, as appropriate. In these circumstances, the increase in your premiums will be limited to the amount necessary to cover the increase in the cost to us of providing cover.

Your membership is subject to the payment of a monthly plan fee of £3.30, which we collect as part of your premium. If you have more than one Friends Life Individual

If any other Friends Life Individual Protection membership you have ends, for any reason, we have the right to increase the premium on your membership. We will only increase the premium by the amount of any plan fee forming part of the premium of the membership which has ended.

Your registration certificate will show whether your premium option is ‘guaranteed’ or ‘renewable’. The effect of these different options is explained below.

Guaranteed premiums

•

if your premium option is guaranteed, your premium will remain the same for the term of the membership unless:

– premiums increase if the benefit is increased, for example if an indexation option is selected; or

– changes to your premium are required in accordance with reasons set out in the ‘General information’ section of the membership handbook, as

appropriate. Renewable premiums

•

if your premium option is renewable, your premiums may increase or decrease at each renewal without the need for further medical evidence based on the age of the member and our premium rates at that time. Your premiums will almost certainly increase on each renewal date because of an increase in the age of the member

30 |

•

we will write to tell you about any change to your premiums at least 60 days beforehand

•

if your premium needs to increase, you can tell us to keep the premium the same and reduce the amount of benefit instead. Alternatively, you can cancel the

membership and stop paying premiums altogether

•

we may also increase your renewable premium on the renewal date as set out above and in accordance with reasons set out in the ‘General information’ section of the membership handbook, as appropriate.

32 |

How to make a claim

If you wish to make a claim in relation to your membership, please contact us at: Friends Life Individual Protection - Claims department

PO Box 569 Friends Life Centre Bristol

BS34 9FE

Or telephone us on 0845 600 3122. Calls may be recorded and may be monitored. You must make your claim as soon as you reasonably can.

When initially notifying us of a claim please provide the following information:

•

details of the person(s) dealing with the claim - their name(s), address and telephone number. In some instances this may be a third party i.e. a solicitor, next of kin or executor

•

details of the member suffering a fracture

•

the nature of the illness, disability, or cause of death

•

relevant dates - for example the date terminal illness was diagnosed, or date of death

•

the registration number under which you are making a claim - this can be found on the registration certificate. However if you cannot locate this, we will be able to assist, we will need to know:

– the name of the member, their date of birth and their post code.

Once we have this information we will be able to confirm that a claim can be submitted to us to consider and we will then forward a claim form, reply paid envelope and a short aid detailing the next steps required for the claim to be assessed.

You must return the claim form to us giving us any written information or proof we reasonably require to establish your claim. We will need evidence, where appropriate, of:

•

the member’s death (for example, a death certificate); or

•

the diagnosis of a terminal illness; or

•

the member’s total permanent disability; or

•

any illness or injury the member suffers. In order to establish that a member has a terminal illness, total permanent disability, illness or injury, we may require that the member undergoes a medical assessment. We will pay the cost of this medical assessment.

Where we receive a claim for total permanent disability or terminal illness benefit and the member is resident outside of the UK, we may ask the member to attend a Friends Life and Pensions Limited approved hospital for assessment. In the event we cannot obtain the evidence we require to assess the claim, we also reserve

the right to request, where reasonable and proportionate to your circumstances, they attend a Friends Life and Pensions Limited approved hospital in a different country. We will meet the costs of the assessment itself, but not any expenses incurred in attending. We may also require evidence that you are entitled to the benefit. For example, in the event of a death of a sole trustee of the policy we may need evidence of the appointment of personal representatives (or an executor) who will become the new trustee.

Once we reasonably consider that we have enough information or proof to establish your claim, we will pay the benefit to you. Where we reasonably consider that you have misled us (deliberately or recklessly) by either giving us false information or by keeping relevant information from us relating to your membership or claim and in those circumstances we shall have the right to cancel from the start of the membership. However, where that information was given carelessly or a failure to disclose relevant information was careless then we shall have the right to amend the terms of your membership to be consistent with what the terms should have been based on the correct information, unless we would not have offered any terms for the membership in which case we shall have the right to cancel the membership from the start and return

Replacement cover

If your membership covers more than one member, when we have paid the benefit to you for one member, you may take out a new membership covering the other member, provided that:

•

you tell us that you want to take out the new membership within three months of the date we paid the benefit to you

•

your membership could have continued for at least five years after the

commencement date of the new membership

•

the member to be covered by the membership must be under 50 years of age

•

the amount of cover to be provided by the new membership is not more than the benefit provided under your original membership

•

the new membership will not continue beyond the date your original membership would have ended

•

the total permanent disability option can only be included in the new membership if it was included in your original

membership

•

we accepted your initial application for cover without increasing the premiums above our standard rates at that time or applying any special conditions to your original membership

•

the new membership is provided under the terms and conditions we apply at the time the new membership is taken out. For information on replacement cover, please contact us at:

Friends Life Individual Protection PO Box 569

Friends Life Centre Bristol BS34 9FE

Or telephone us on 0845 600 3122. Calls may be recorded and may be monitored.

36 |

Your right to cancellation

You have the right to cancel the

membership and have any premiums paid refunded if you cancel within the 30 day period from the date you receive your registration certificate and this handbook. Confirmation of your request to cancel should be in writing sent by post to the contact details below. Please note that if you have a joint life policy, we will require both schemeholders’ signatures on any cancellation correspondence.

Once we have been notified of your request to cancel (within the 30 day period) we will refund any premiums that you have paid to us.

If you wish to cancel your membership at any other time, please write to us at the address shown below.

Friends Life Individual Protection PO Box 569

Friends Life Centre Bristol

BS34 9FE Tel: 0845 600 3122

Calls may be recorded and may be monitored.

We will write to you to confirm the cancellation of your membership.

Please note that outside of the initial 30 day cancellation period, no refund of premiums will be due unless:

•

you have paid an annual premium and you cancel your cover before the next premium is due. In this case, provided no claim has been made, we will give you a pro-rata refund but we will deduct the discount you would have received in that year for paying an annual premium; or

•

you cancel your membership in

accordance with changes to these terms and conditions outlined in the ‘General information’ section.

Friends Life Individual Protection memberships have no surrender value.

38 |

General information

Changes to your registration certificate If we need to change any details on your registration certificate, or add new details to it, we will send you a new registration certificate or an endorsement, providing the most up to date details of your membership and will replace any earlier registration certificate (including any endorsements to it). Your registration certificate will show the date on which it replaced the earlier registration certificate. Assigning and surrendering your membership

Your membership has no surrender value. You will not receive any benefit or refund of premiums when your membership ends. If you assign your membership, you or the assignee should provide us with written notification of this.

Changes to these terms and conditions a) We reserve the right from time to time by giving you 60 days notice, so far as it is practicable to do so, to make such changes or additions to this membership handbook as may reasonably be required to reflect: - any change of law, regulatory requirement

or taxation

- changes to services relating to your policy supplied to us by third parties which are outside of our control or which require additional expenditure by us

- changes in circumstances or the happening of any event which is outside of our control which means that the policy’s terms and conditions operate in a way which is unfair to you or our other members

- changes resulting from the introduction of new systems, services, and changes in technology outside of our control

- changes in circumstances or the happening of any event which is outside of our control and which makes it impossible,

impracticable or economically unviable for us not to make a change to the terms and conditions, provided that any such change is not unfair to you or our other members - changes required to remedy obvious errors. b) We reserve the right, from time to time, to make changes or additions to this

membership handbook for any

administrative or other reason, which may or may not have a detrimental effect on you and which are not set out in a) above. If you suffer a material detriment as a result of a change or addition to this membership handbook under this paragraph b), you may notify us and you will be free to cancel your policy. In that case, we will give you a pro-rata refund of any premium you have already paid for the period following the date of cancellation, unless a claim for benefit has already been made under your policy.

General information

Changes to your membership Only we can make any changes to your membership (in accordance with our rights under your membership) confirm any changes you have asked for or decide not to enforce any of our rights. Any change to your membership will come into force only when confirmed by us in writing.

If we delay our decision to enforce our legal rights, this does not prevent us from enforcing those rights in the future. Written communication

We will send any letters to you to the address you last gave us. If you change address you must always write and tell us. If you write to us, you must send that letter to:

Friends Life Individual Protection PO Box 569

Friends Life Centre Bristol

BS34 9FE

You and we can assume that a letter has been received three days after it was sent by first class post.

Choice of law

Friends Life and you have a free choice about the law that can apply to a contract. Friends Life proposes to choose the law of England and Wales and by entering into this contract you agree that the law of England and Wales applies.

Jurisdiction

The Courts of England and Wales have non-exclusive jurisdiction over any claim, dispute or difference which may arise out of, or in connection with, the terms and conditions of this membership handbook.

Getting in touch

Our helpline is always the first number to call if you need help or support or if you have any comments or complaints. Please call us on 0845 600 3122*.

Alternatively, you can write to us at: Friends Life Individual Protection PO Box 569

Friends Life Centre Bristol

BS34 9FE

*Calls may be recorded and may be monitored.

Making a complaint

If you have not been able to resolve a problem and you wish to take your complaint further, please write to Customer Relations at the address above.

It’s rare that we cannot settle a complaint, but if this does happen, you may refer your complaint to the Financial Ombudsman Service. You can write to them at South Quay Plaza

183 Marsh Wall London E14 9SR

www.financial-ombudsman.org.uk Email

complaint.info@financial-ombudsman.org.uk

Please let us know if you want a full copy of our complaints procedure.

If something has gone wrong, we want to do everything we can to put it right. But none of these procedures affect your legal rights. The Financial Services Compensation Scheme (FSCS)

In the unlikely event that we cannot meet our financial obligations you may be entitled to compensation from the Financial Services Compensation Scheme. This will depend on the type of business and circumstances of your claim. The FSCS may arrange to transfer your membership to another insurer, provide a new policy or, where appropriate, provide compensation. Further information about compensation scheme arrangements is available from the FSCS on 020 7741 4100 or on its website

www.fscs.org.uk.

This document is available

in other formats

If you would like a Braille,

large print or audio version of

this document, please

contact us.

Friends Life and Pensions Limited

An incorporated company limited by shares and registered in England and Wales, number 475201. Registered office: Pixham End, Dorking, Surrey RH4 1QA. Authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority.

Telephone 0845 600 3122 – calls may be recorded. www.friendslife.co.uk

Friends Life is a registered trade mark of the Friends Life group.

FLIP/4574/Jan14 86127 UNI

For more information, please contact us on:

0845 600 3122

†

Friends Life Individual Protection, PO Box 569,

Friends Life Centre, Bristol, BS34 9FE